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The Mel Lawson Show
I'm Mel Lawson, mum of 3, Founder and CEO of Bare Biology (a UK supplement brand). Basically, we talk about life. From psychology and health to self-development and spirituality, and much more. We have experts, we have fascinating guests, and we talk in a very open and honest way. We share our vulnerabilities and hope to entertain and inspire you, maybe make you laugh, and possibly help you experience some ‘aha’ moments along the way.
The Mel Lawson Show
Period problems? Listen to this | With Tanya Borowski | The Mel Lawson Show
In this episode, Women’s Health Specialist Tanya Borowski shares her insight around managing difficult menstrual cycles, from crippling pain to mood swings.
More from Tanya here.
This episode is sponsored by Melanie's family-owned UK supplement company Bare Biology.
Welcome back to another episode with Tanya Borowski, functional medicine practitioner and all-round brilliant women's health expert. Hopefully you'll have listened to our previous two episodes and the one before this, which is all around understanding in great depth the menstrual cycle and the menstrual cycle when it starts so in teens, and in this episode we're going to talk about really great things around what you can do to help your teen or, if you are a teen listening, how to help yourself if you have problem periods, so issues with pain, acne, heavy bleeding, etc. For the people who are listening and not watching on YouTube, if you'd like to see the slides that Tanya refers to, we will put them in the show notes or you can watch on YouTube, so we'll go straight into it.
Speaker 2:Great.
Speaker 2:Thank you, mel. So, yeah, we're in this session session. We I'm going to be covering what we would call problems, uh, with that can. That can occur with periods. So we're gonna, um, just to reassure, we're going to cover off, uh, if you're experiencing heavy bleeding and what constitutes what constitutes heavy bleeding to get help, help you signpost that. We're also going to be talking about when is a period considered to be, or when is a menstrual cycle considered to be, irregular. So we're going to cover off that and I'm also going to be talking about PMS and mood symptoms. And then we're going to be doing a completely separate episode on the pill and also on acne. But we did, we will, I will be touching on acne today as well.
Speaker 2:So within that, I think, the first thing that I'd like to sort of cover off, we spoke in the last episode about just allowing time for this journey to begin. There's a long road ahead and there are going to be sort of bumps along the road and so allowing for that to begin. So I just sort of would like to sort of start by when might you think about consider consulting a doctor? What, at what point is that important? So, if there are signs of puberty before the age of eight, then that is a little bit of a flag and would be worth a trip to, worth a trip to the gp. Um, if there is no sign of any sexual characteristics so pubic hair, underarm hair, the breasts budding if there's no sexual characteristic signs by the age of 14, if menarche so menstruation doesn't kick in within three years of the breast developing, and if there has been no menarche or no menstruation by sort of 16, those would be flags that you might want to. That you should go and speak to your GP is the first point.
Speaker 2:So if we then move on from that and we say, okay, well, the term irregular is used, so much isn't it? Yeah, so what actually constitutes an irregular period? And this isn't in the NICE guidelines, this isn't. Again, this is very indicative of how sort of poorly women's health and menstrual cycles have been considered. But what we? Through my lens, we're talking about irregularity as if there's been two or more years that have passed post-menarche and we remember that menarche is the first day where all the balloons go into the sky and the rockets start when your first period starts. That's menarche. So if two or more years post that and cycles are consistently shorter than 21 days or longer than 45, and again, remembering that teen cycles are quite often 45 days. So we're having to wait until at least two years or more for that to constitute in a regular cycle. Okay, then we want to be able to understand.
Speaker 2:And then the other really important thing with that so within that time really important the pill cannot regulate cycles. It suppresses ovulation. So the pill, even though it is prescribed to regulate periods, still it absolutely cannot do that. It is a complete dichotomy of terms. It absolutely can't do that. Ovulation is the main event, is the ta-ta moment of the menstrual cycle, and the pill prevents that. So that's a really important one. And we can think about the pill that those hormones are basically flat lines. They're not ebbing and flowing in the way that they naturally would.
Speaker 2:So when we think about cycle irregularities, let's just have a reminder that what we consider to be a healthy adult cycle is anywhere between 21 and 29 days. Okay, and this is like so that you begin to get into your pattern of what that is. Teens have a longer cycle because they have a longer follicular cycle. There's more of that building because those follicles are kind of vying for position and they're pumping out a lot of oestrogen. So they can be sort of 32 days and generally a health. So a healthy teen cycle can be anything from 21 days up to 45, and they will vary within that as they get going. So when there is what we call amenorrhea, which means the absence of periods in teens, let's go through what the checklist should be. Does that all make sense so far? Any questions?
Speaker 1:Yes, it does. So one thing that stood out to me when you said 21 days, I think most mums would think oh, they're having periods very often. That 21 days goes quite quickly.
Speaker 2:And now do you know why? Without wanting to sound, remind me, okay, so 21 days is that? Is that they? It's because they're probably not ovulating, so they're not producing progesterone, right? So they're having that longer follicular phase? Yes, and they're. And if they're 21 days, so they're not having, or they're having a very short luteal phase, or they're not having a luteal phase, so they're not ovulating. So that's why so that's very commonly why they jump around all over the place.
Speaker 1:But you could think, oh, that doesn't seem right.
Speaker 2:But again, relax, wait, give it a while you need to give it at least two years at least two years, sort of like, yeah, year one post-menarche and say these are wrong.
Speaker 2:because again it's like what is that? Yeah, in every textbook and this may be sound, this maybe sounds all it's one day difference. Does it really make a difference? But every graph that that you see, every textbook you see, the menstrual cycle is 28 days. Well, in actual fact and I learned this from the wonderful Dr Nikki Kay is that actually in truth, the average menstrual cycle is 29 days. Right, but for ease of maths, because you can, then you can divide 28 into an even number. You can say, oh well, you ovulate on, et cetera, et cetera.
Speaker 2:Yeah so it's, it's, yes, it's about establishing that rhythm for that individual.
Speaker 2:Yeah, and it's very individual and it's very individual.
Speaker 2:So the key thing and I love your analogy that you used in the last episode of the orchestra and learning how to blend and learning how to listen to the conductor, who is the pituitary, and it needs a lot of practice.
Speaker 2:The other analogy that I've used and may be helpful for mums listening to understand when your daughter has her first period, with that celebration, it's like her learning to drive a car. It's exactly the same as when you sit in that passenger seat for the first time. She is going to stall down the road. She is going to nearly drive into the lady walking along the pavement. It is going to take a lot of practice of getting in and out of the car and experiencing different things within her environment the time of day, the weather, the lighting. All of that can be translated to the human body in terms of those are all the signals that the brain is sensing about whether it is still safe to go through this process. So that is why and it is a learned pattern so they will jump around all over the place to start with.
Speaker 1:Yeah, great yeah, thank you.
Speaker 2:Brilliant. So if there then is the absence of periods that become more, yeah, the young woman has started her period, uh, two years ago, and then now she's gone six months without having a period. These are the most common reasons. Of what we need, first of all, the most obvious one is could she be pregnant? Amazingly, that's overlooked quite a lot, um. And then we think about again, through a more holistic lens, what I would call the roadblocks to ovulatory cycles. And it's our job and we are far better placed, through this lens, this more holistic lens, to be thinking about removing those roadblocks rather than just trying to quote, quote, regulate the cycle through the pill.
Speaker 2:So we want to be thinking about is there a medical condition that hasn't been uncovered? So, a very common one might be celiac disease. So it's an inflammatory condition related to the GI tract, to the gut. But if there is any significant, unrelenting inflammation that hasn't been identified, then on a fundamental level, that's sending messages to the brain called cytokines, saying there's danger, there's a danger response. So that could be enough to prevent menstrual cycles if there's any ongoing aberrant inflammatory response. Um, they would also want, you'd want to check um, whether there is something called um. It's very most commonly is benign, but a benign tumor on the pituitary gland which causes high prolactin. That is the hormone that we that we release, uh, when we're lactating. But actually if there is a benign tumour on the pituitary that's pushing on the pituitary, it can release hyperlactin and that will prevent period. That will prevent ovulation. Which is why when we're breastfeeding, you can't become pregnant as well?
Speaker 2:Yeah, very unlikely and there can be genetic reasons, um, and it's not overly common, but there's a. There's a genetic um condition called turner syndrome and that can be a reason that would need to be done through a um, through your, through that, through your gp, um nutrition, severe nutritional deficiencies, so either specific nutrients, so if you're chronically anemic, if you're chronically low in vitamin D, zinc, any of the essential fatty acids, but also, under that umbrella, if you're chronically undernourished, so disordered eating. That's a massive signal to the brain we're're not safe, we're not getting a consistent level of nutrition here. Then the brain will the, it will shut down. So um, and then the, the two most common areas that we want to be thinking about when there is an absence of periods for um, for when there's an absence of periods are is something called hypothalamic amenorrhea. So hypothalamic is the brain, the hypothalamus is the brain and amenorrhea, we've just learned, means the absence of period.
Speaker 2:So this means it's brain-based. It basically means the brain is saying no, thank you, this is not a safe environment. No, thank you, this is not a safe environment. And most commonly it's due to being under. It's under nutrition, being undernourished and combined quite often with overexercise or just pure overexercise. So this is common in young girls that do gymnastics, do sort of you know, athletics, and I'm absolutely not anti any of those. But again, like anything in life, there is a balance and that uses up significant amount of energy and the brain is just sensing that there is not enough energy to go around. So it is uh, it will dial down and turn off this very energy demanding process.
Speaker 1:So in that instance would you recommend? If there's a girl I have a friend whose daughter is extremely sporty, is in every A-team, dances five times a week does she need to eat more, because obviously she wouldn't want to give that up? What would be your advice?
Speaker 2:Yeah, you do you really want to be? I mean again, it does depend on their frame, but in someone is doing that level of activity at that, to that degree every day, then really they're wanting to be consuming 2,000, 2,400 calories a day and they really need to be, consuming 2000 2400 calories a day, and they really need to be ensuring that they're getting sufficient whole grain carbohydrate as well, because that's fueling their gluck, that's provide for giving them glucose and storing their glycogen stores right, so not be on a low carb diet.
Speaker 2:Absolutely definitely, definitely not being on a low-carb diet.
Speaker 1:Right, yeah, that's useful yeah.
Speaker 2:Yeah, yeah. So that's the one big area. And then the second area is when there's high androgens. So we spoke in the first episode of this series about the awakening of the adrenal glands, adrenarche, which is high androgens, and so these are male like hormones. And um that, when there's, when those high androgens aren't naturally suppressed and the beginning of the menstrual cycle, oestrogen starts to dampen that down.
Speaker 2:One mechanism it, the way it does that is that estrogen produces, helps to increase the levels of what is called sex hormone binding globulins. And sex hormone binding globulins are like little taxis that hormones jump into to be able to travel around the body. Okay, because they're made. They're predominantly our sex hormones are made of fat, they're steroids, they're made of fat, cholesterol, and so the blood is mainly aqueous, it's made of water. So we don't have just hormones floating around free in blood. They jump into these little taxis which are called sex hormone binding globulins and oestrogen. When we start to produce, oestrogen helps more taxis, the production of more of these taxis, to go out onto the rank. So and they preferentially go after androgens. So the beginning of the menstrual cycle helps just to counterbalance that adrenarche system. And then the second component is when we start to ovulate. Progesterone also is really anti-androgenergic, so it helps to calm down those androgens as well.
Speaker 2:So, persistently, the most common cause, the most common reason at this age of well, the most common diagnosis that's given when we have high androgens is PCOS. Okay so, and this is really important. So PCOS is actually is a condition of androgen excess and irregular periods when all other causes have of that androgen excess have been ruled out, of that androgen excess have been ruled out. Okay so, and there can be a number, and one in particular that needs mentioning, that actually, that I would suggest that every girl that has been that is being suggested, that is given. This diagnosis is something called congenital adrenal hyperplasia and this can occur in one in a hundred women, young girls, and this is, and one in 100 women, young girls, and this is, and it's basically when the adrenals it's a genetic reason just basically keep pumping out high levels, high levels of those of those androgens. Okay, and the hypothalamic amenorrhea is a lack of periods or irregular periods that's predominantly caused by negative energy balance. So does that make sense? Yeah.
Speaker 2:So it might be important now to let's kind of compare and contrast what that might look like in terms of symptomology, because I think that can be helpful. Yeah, so PCOS there can be absent periods, or there can be long or there can be short cycles, versus with hypothalamic amenorrhea generally there's just completely absent periods.
Speaker 2:Okay, okay, okay so with PCOS they tend to be more irregular, so they can go. You can go maybe 45 days and then have a period, and then you might go another 45 days and then you might go 21 days. But with hypothalamic amenorrhea it's just just this constant not not having a cycle, not having a period. Okay, with pcos. Again, to remind us, pcos is a condition of high androgens. That's, either we either is diagnosed, either clinically, ie we look at the symptoms. So this would be jawline acne sort of hirsutism, so facial hair, and not just a dusting but sort of like quite thick sort of facial hair, which is obviously very distressing for women. Hypothalamic amenorrhea is more that sort of anorexia type, more downy type hair that you might see, rather than it being that sort of much more coarser, thicker hair of PCOS. Does that make sense?
Speaker 1:yep, it does. So are you saying that if, if a girl is presented with no periods at all, it's unlikely to be PCOS, but if a girl, let me get this Okay yeah. Maybe let's explain it again, because if I'm not understanding it, yeah, let's explain it again. So PCOS.
Speaker 2:First off, it's a condition of high androgens, so that needs to be present, so that has to be present.
Speaker 1:That has to be present Because you can't have PCOS without high androgens, correct?
Speaker 2:So PCOS is a condition that has high androgens. So the high androgens can either be diagnosed, either by observing the woman clinically, and those clinical signs are jawline acne.
Speaker 1:It's quite, it's quite and it's obvious, is it very around the jawline rather than?
Speaker 2:all over? Yes, yeah, that's right. Um, and sort of and facial hair much coarser, sort of denser facial hair, yes, and then or so that's the clinical diagnosis or the presence of high androgen, so high testosterone or high DHEAS, on a blood test. Okay, and you'd need a blood test to determine that?
Speaker 1:Yeah, but you can diagnose the high.
Speaker 2:If they're displaying those clinical signs, then those are clinical signs of PCOS.
Speaker 1:Can you have PCOS without those visible clinical signs?
Speaker 2:So actually, I think what would be helpful is so because this has. Actually, I think what would be helpful is so because this has changed. So the diagnostic criteria for PCOS is that it requires two of the following so clinical or biochemical, ie clinical, we've just described, or a blood test of hyperandrogens, right, the second? So you need two out of the three. The second is ovulatory dysfunction, so irregular cycles Okay, so that doesn't necessarily. When it says ovulatory dysfunction, that doesn't mean a complete absence. It can be that irregularity. And then the third is polycystic ovaries. On ultrasound Okay, so you need two out of the three.
Speaker 2:Now, brilliantly, last year these guidelines were revised, and very especially for adults, where the recommendations are, I quote we do not recommend ultrasound as the diagnosis in adolescence and adolescence is 18 and under, because there is too much of an overlap with the normal physiology of what is happening. Go back to what we talked about in the last session. If we ultrasound every single teen girl as that cycle is getting going, what do we see? We see all of those follicles releasing lots of oestrogen. They're all doing what they're told. That FSH is being. The conductor is saying come on, follicles, get going. We want you to start developing, start growing, and so every teen girl will have a number of follicles. That's kind of stepping, putting them, throwing their hat into the ring to be the chosen one to be the dominant follicle. So this is the normal physiology of what is happening in adolescence. So and and you compare this with, you've also got the flip side of, you've got that those adrenals have awakened so you could quite easily mistake those symptoms of high androgens. And then if you use the second diagnose, that third diagnostic criteria of you run an ultrasound, that is why so many young women walk out of a doctor's office with a diagnosis of PCOS. So if we dial that back and say, okay, so they basically under 18 we are looking for, there has to be clinical or blood test results of high androgens and then there has to be ovulatory dysfunction okay.
Speaker 2:And then we also have to rule out for that all other areas have been ruled out and for that and that could be, they could be having. They could have thyroid disease, it could be hypothyroidism. Again, it could be high prolactin and actually quite commonly there's a bit of a dance between thyroid and prolactin. So if somebody has got an issue with their thyroid, it can actually push up their prolactin levels. So if you address the hypothyroidism it might bring that, bring down the prolactin levels. So this is just to rule out other reasons of high androgens. Um, the congenital adrenal hyperplasia. So that's the blood test that the doctor would do.
Speaker 2:And then the other area is that if the hopefully not but if the girl, if the, the young woman has been put on the pill, and if they have been put on a, there's a type, there's a certain group of pills that we'll go over in great detail, but something like Yasmin or Lucet or Yasella. These are all types of pill that actually suppress androgens, suppress those types. But if they then come off, that very commonly there can be a surge of that androgen production. So all of those have got to be ruled out. So to sort of dial that back, we really need to be. If they've got irregular cycles and if they're showing signs and symptoms of those high androgens, we first of all need to rule out that thyroid isn't involved, there's not high prolactin, they haven't just come off the pill and the adrenals aren't involved. Then we can move forward. I know it's quite complicated, but hopefully Well.
Speaker 1:I have my own story of a PCOS misdiagnosis.
Speaker 2:Go on, share that with me, Do you want me?
Speaker 1:to share it, please do, okay, well, so I went on the pill age 19, to quote, regulate my hormones classic, and you know I had painful periods but they probably weren't abnormally painful.
Speaker 1:I came off the pill when I was about 30, 31, probably 30 right, okay okay, and then thought, and I was, and I got married and oh, I have a baby. Where's where's the baby and sort of I don't know. Maybe six to nine months had passed and nothing was happening. So, being impatient and not understanding that my cycle was sort of getting back into its flow yeah.
Speaker 1:Took myself off to a very prestigious private hospital in London where they do women's health and saw a very senior gynecologist, Okay who and I. I had no visible signs of androgen excess. I had like nothing. I'd never even heard of PCOS. So they did an ultrasound and I imagine that this was happening, that this was happening. My follicles were all going oh, me, me, me, me, me.
Speaker 1:Hello hello, I'm back. And they went oh, you've got PCOS, Outrageous, yeah. So then they put me on medication to help me get pregnant Clomid, yeah, oh yeah. And that all ended badly. I did get pregnant, but it ended badly, Okay. So then I just thought I'm just ditching all of that. I don't even know if I had PCOS. You know when your instinct is just that's not right, that doesn't seem right. Anyway, it was all well, that ends well. But that was and I remember you talking about this in your lecture and I was like that is me, textbook me, and I was so wrongly diagnosed, and so you were put on the pill at 19 and then you came off it.
Speaker 1:I think it was 30. So over a decade later, yeah.
Speaker 2:Yeah, so there was very, and you said before in our first episode, you started your periods at 15.
Speaker 1:I think 14.
Speaker 2:Okay so it had had. The symphony was beginning to get into a bit of a, into a real rhythm. Yes, and then it was completely switched off. Yes, for a decade. Yes, and then what was being viewed on the ultrasound were those was that the conductor of the orchestra was tapping his baton saying, okay, we're ready to go again. Follicles. So the follicles were beginning to waken up. Yeah, and yeah. Yeah, snapshot in time, you take a photo of that. Yeah, didn't. That doesn't follow any of the criteria. None of you needed. You need to have two out of the. So you didn't have. Well, you had a regular cycle, so that, uh, um, so had your period started? Yeah, my cycle was regular. Okay, so that's. Yeah, that was a complete misdiagnosis because you weren't having a regular cycle.
Speaker 2:Acne facial hair and you had no signs of androgens.
Speaker 1:No.
Speaker 2:So you only had one out of the possible three, and you need two out of the three.
Speaker 1:Yeah, yeah.
Speaker 2:Are there any?
Speaker 1:sorry are there any stats on PCOS over-diagnosis? No.
Speaker 2:I mean, these guidelines were only. That was only changed last year, very recently, yeah, just the back end or middle of 2023.
Speaker 1:Yes, I remember Nikki Kaye talking about it.
Speaker 2:And that is, I mean, that's a wonderful step forward for women's kind. Yeah, because hopefully it will begin to alleviate this just shameful sort of over-diagnosis of a label that is. And then we see this a lot, don't we that actually, then it's very, it's kind of built into our psyche that we then quite then we become that label yes, and we see that with a whole number of diagnoses around women's health and yeah, and it can be very disempowering and very, yes, yeah.
Speaker 1:And from a sort of neuroscience point of view not that I'm a neuroscientist- it's something you've been hiding from.
Speaker 1:Yes, well in my spare time. Um, your brain believes what you tell it, yes, and then it will start actually doing the things that you're telling it. So if you think you're ill, for example, so you know how, I remember seeing a comedian years ago and he started talking about his um when he had the snip, oh yeah, and a guy in the audience fainted, keeled over, and then two other people keeled over straight after and I thought, holy god, we're being attacked. Someone's just pumped some sarin gas in here or something. So that's the way my brain works. Not dramatic. And I said not, not at all. And I said to clive, my husband we need to get out, they're poisoning us. And he went no, it's because he was talking about the snip. And then one person faints and then it's sort of contagious, because you think, oh god, you know, and, and it is, if you think you're ill, you can actually feel those symptoms. It's amazing, the brain is so powerful. Yes, yes.
Speaker 2:So yeah, and these are, and also the terminology, the vernacular, they're really sort of just very unpleasant terms when we think like premature ovarian insufficiency.
Speaker 1:Yeah. Polycystic ovary syndrome If you're 14.
Speaker 2:I mean they're not cysts, they're follicles, so they're. They're baby follicles, they're not. The terminology is not even right. They're baby follicles, you hear the word cyst.
Speaker 1:So you think this at all pretty much goes straight to cancer?
Speaker 2:yeah, they're not cysts, uh, ovarian insufficiency, um. So it is. These are these very, very powerful words.
Speaker 1:Yeah, especially for a young teen and then an anxious mother. Yeah, so mum's listening. If you think maybe your daughter has PCOS or your daughter's on TikTok a lot and self-diagnosing, which I think happens a lot, so go back pause.
Speaker 2:Listen to those three areas. Yeah, got to be. They've got irregular periods. You can't. The diagnosis, don't?
Speaker 2:The ultrasound diagnosis is completely not fit for purpose for 18 and under. So they need to have those the irregular periods and signs of androgen, either clinically or on a blood test. Great, clinically or on a blood test? Great, yeah. So if then the you have a daughter that has actually been diagnosed properly, what can we? So what can we do?
Speaker 2:Um, because, again, that quite commonly then what is prescribed is metformin, because insulin resistance it is not a cause of, it is not a cause of pcos, it is quite it is common to run alongside with a diagnosis of pca, pcos. But, and this is why I don't understand why, when a diagnosis of pOS is given immediately the treatment is to put someone on metformin, which, without actually looking to see do they have insulin resistance? Let's look at their fasting insulin, let's look at their, or let's do an oral glucose tolerance test. So that would be the first thing to do, but holistically, again through our lens, there is so much that we can do within the heterogeneous, ie there are many different types of PCOS that we can support. So the first thing is diet.
Speaker 2:I'm a nutritional therapist, so of course I'm going to approach it through diet. So a whole food food plan and I use the term food plan rather than diet because we really don't want to be using that word if we want to avoid that and we want to be focusing on foods that are as close to their natural evolution as possible. So that's what I mean by whole food. So it's good levels of protein and, interestingly enough, today when we were having our lunch break, I sat next to a table of probably a group of young women in their 20s all talking about how much protein they were having. So there's some awareness of that.
Speaker 2:So, that was, yeah, managed to not butt in um so high protein. So just the so protein is animal protein, meat, fish, um, eggs are a fantastic source of protein. Um, just whip up an omelette fantastic lots of fiber. So getting from, uh, from plants. So whole grains, um, brown rice, brown pasta I mean I know a lot of people don't like brown, um, brown pasta. So I can, I can live with a bit of white pasta, but try to have the wild rice or whole grain basmati rice, cook it in, cooking it in a bit of stock. Actually it's really it makes it more tasty and maybe doesn't taste quite so worthy. Um, and that's actually a really nice way to incorporate that.
Speaker 2:Um, when I say low sugar, I mean just being mindful. Again, you don't want to create this as a diet, but it's just thinking about where those maybe excess sugars come in. And especially this is very classic at this age, when we think back to when our girls were that sort of 13, 14, when they start to come into town on their own with their girlfriends and they go and sit in Starbucks, costa, and they're taking in a lot and they're ordering these frappuccinos and um, it's just thinking where there's more of this excess sugar that is coming in, without being like creating disordered kind of over parenting sort of parachute parenting it is. I totally understand. It is a, it is a fine line and hydration sounds really simple. But just ensuring they go out the door with a water bottle and they will, that will really help even just balance sugar cravings, um, because with irregular periods then actually that can also cause more cravings because those hormones are not regulated, um, and so just make ensuring that someone is, you're hydrated actually can help to, can help to temper that. So that's a real big, great regular exercise, uh, doesn't need to be excessive, but just getting out moving, even just there was a big difference I noticed with my daughter when she moved from school and then she went to a sixth form college and she was walking back and forth on the train and all. And that just makes such a difference because your biggest muscles are at your quads and so you're that's helping to dispose of that glucose as well. So X movement is really important.
Speaker 2:And then, in terms of supplements, the two big ones that I would think about, if it is you're confident, is a diagnosis of PCS. Number one is zinc. So the dose, so, and again reminding there's very, very little zinc in plant foods, and a lot of this age group are really gravitating towards veganism. So you want to be taking 30 grams with your largest meal, and zinc helps to increase progesterone and decrease androgens, and that's what we wanted to do with in PCOS. Okay, so zinc and then a. It's actually a form of a bean nutrient called myoinositol, and myoinositol is like an intracellular ie inside of the cell. It's like a second messenger. And it's a second messenger especially for FSH, follicle stimulating hormone, so it's kind of like a security blanket, it's like the Hawkeye, and also for insulin, so it facilitates a more normal response to insulin and thereby improves insulin sensitivity. So myonositol and the dose is four grams a day, and take it in divided doses, so it's easier to take it in a scoop, in a powdered form rather than taking.
Speaker 1:It Sounds quite a lot, yeah.
Speaker 2:So you yeah, you need to go quite high with this. So it's, it comes in a powder.
Speaker 1:Right, and that's easily found.
Speaker 2:It's not one of those. No, no, no, you can find that you can't get here here.
Speaker 1:Yeah, you can easily find that and you mentioned zinc earlier and you said 30 grams. Do you mean milligrams 30?
Speaker 2:yes, yes, yes, I thought we'd just clarify 30 milligrams someone's trying to get 30 grams of zinc. Thank you.
Speaker 1:30 milligrams and we have did mention this in the previous episode, but may not have listened or remember. Uh, zinc biscolysonate is a nice yeah, that's a nice form and have it with dinner, a big meal, because otherwise it can make you feel sick. Yes, yeah, and my teenage son and daughter eldest daughter both take it with dinner 30 milligrams. They don't feel sick. They would feel sick if they took 30 grams.
Speaker 2:They would feel really ill, so I thought we'll just say yes.
Speaker 2:Sorry, that's being a bit flippant here, but um yeah it's absolutely thank you for picking me up and the nostril you can get from, yes, so, um, yeah, practitioners, you can get it through amrita nutrition or you'd someone, someone, you can get it through some, uh, someone like supplement hub. Um, yeah, yeah, great and really reputable brands. Yeah, yeah, there is a place in in adult women to use what we call cyclical progesterone. So this is body identical progesterone that is used in hrt, so this is and you can use it in pcos. You can use this cyclically, so you can use it two weeks on two weeks, because if we remember what progesterone does, natural progesterone is it calms down luteinizing hormone and PCOS is a condition of high luteinizing hormone. So we need that ovulation, we need that progesterone to kind of calm that down.
Speaker 2:So there is a really fantastic paper that was written by Professor Geraldine Pryor and Lara Bryden, who is a wonderful naturopathic physician, and they wrote a paper where using cyclical progesterone in PCOS to re-regulateulate the cycle, and you cannot do this with the pill, because the pill doesn't contain progesterone, it contains a progestin. So the pill would not work and be advantageous in this way. But I would be hesitant to go straight in with cyclical progesterone in a teen or a tween. Maybe if they're nudging more towards 18, 19, 20, then I would, you know, and those other interventions hadn't hadn't kind of hadn't kick-started things, um, but yeah, you don't need to go in with the big guns first off and I guess with a teen you wouldn't ideally you wouldn't go down, going on the pill route or the metformin route.
Speaker 1:You would try looking at diet nutrition. Yes, so those elements would be.
Speaker 2:Are working on all of those aspects. Yeah to to support the, to support the acne, um, to try to regulate the cycle, etc.
Speaker 2:Yeah, great, yeah, thank you so then we then move into the other most common reason, which is hypothalamic amenorrhea. So this is brain-based. So basically it's a reaction from the brain that is reacting to a stressor and the hypothalamus is sensing danger. So it's downregulating and the most common reason for that is inadequate calories, so too few calories basically shuts down luteinizing hormone. And if you see luteinizing hormone, so LH on a blood chemistry that's very low. So in teenagers you would expect to see luteinizing hormone sort of three, four, uh, two, three, four is the measurement. If you see it at nought point, something, then, or sort of what, one under one, then this is a very good, uh, surrogate marker that there is not enough carbohydrate intake, yeah, similarly, if there's a very low what's called t3, that's the active thyroid hormone, don't shoot the messenger and practitioners out there don't say, oh, we need to treat the thyroid, that you'll shoot. It's shooting the messenger, it's actually the, it's look's the, this the, the body is sensing danger and it's down-regulating. So why is, why is the, why is that conversion low? So those are two very good markers that there's not enough nutrition and very specifically, with the very low t3, in that it's not enough carbohydrate intake. So yeah, and then other reason, again over exercise. So, and we see this with with, actually with professional athletes, um, and actually, uh, there was some really there was a really interesting interview with the women's football squad, the olympic football squad, that was talking about sort of how they really really fill in their power, they, they get it's like a, it's a superpower if they have a match when they are just pre-ovulation, it's like giving them you know there's no test for that in terms of you can't rule them off the pitch, but it is a superpower. So if you can harness that, then that's phenomenal.
Speaker 2:And then mental and emotional stress. So sexual trauma this is a big reason and mental trauma this is another big reason why there would be a shutdown now. This and this is something why it's also really important to take time and listen and create a safe space because and again, sadly, you know the wonderful, the nhs sad, it's just not set up to do that and to be able to hear it's a 10 minute appointment that it could well be that this young girl has had a bad experience at uni, going to uni, or has just felt, has felt overwhelmed, or has been put in a situation he has she hasn't felt comfortable with, and this can be enough of a trigger or the proverbial straw that breaks the camel's back, that actually shuts down those, those messages. So it is this sort of more holistic lens that we view health through. We need to sort of take all that on board around.
Speaker 2:So and I think that is a much more respectful way to frame this than oh yes, this is in your head. Yeah, it is in your head. Hypothalamic amenorrhea is absolutely brain-based. It is in your head, but there's a reason why it's in her head. Does that kind of make sense?
Speaker 1:Yeah.
Speaker 2:Yeah, I really hate that it's in your head. I loathe it. It drives me nuts yeah.
Speaker 1:Yeah, yeah, I really hate that it's in your head. I loathe it. It drives me nuts.
Speaker 2:Yeah, yeah. So nutrients and support for hypothalamic amenorrhea Sort of nutrition is really important. So adequate energy increase. Now, if there is disordered eating, absolutely we are not going to be able to say you need to eat 2,500 calories. I mean, that is just going to be going to. They're just going to completely turn off. I mean that is just going to be going to, they're just going to completely turn off.
Speaker 2:So, and I say this, with the greatest of respect and I fell foul to this early on in my career is that nutritional therapists are not well placed to be able to deal with disordered eating. They need to be under the guidance of a of a psychologist. They need all of that support before they can talk about eating, of quality, of quality food, um, and so the the mental and emotional component of that needs to be supported, and then they need these. These young women need a team of people around, but taking her off to see a nutritional therapist who isn't professionally trained in anorexia bulimia is not actually the timing isn't right, because they're not in the right place to be able to hold that woman.
Speaker 1:Yeah, but there are nutritional therapists who are trained.
Speaker 2:There are nutritional therapists who have gone on to do that specific training, so you can look for that totally, totally qualification yeah absolutely and those are, and I refer to them myself all the time um, and yeah, absolutely, yes, um.
Speaker 2:Now, because this is brain based, uh, the use of something like magnesium glycinate, which helps to the hypothalamus, has um, helps to attenuate the. There are certain receptors that are, they're called ndma receptors, which are very responsive to cortisol and adrenaline, and it helps to and magnesium glycinate helps to, if you like, just sort of calm the receptiveness of those, so that can be very calming to that hypothalamic axis. And then sort of nice herbal, anti-analytics things like ashwagandha and rhodiola, and you will find those in some nice herbal, some nice blends that are suitable for this age group. The other thing that I think is really important to think about is thinking about the gut and thinking about digestion, because a lot of I've heard so many of my daughter's friends just not that I'm listening at the door, promise you um, but just to talk very openly about how commonly, how often they feel bloated and um and have gut issues and and this can very, very easily flip into disordered eating as well and over diagnosis of SIBO or sort of or food intolerances and ruling out of all of these, not just foods, but ruling out of entire food groups. So we have to be really careful about that.
Speaker 2:So actually just supporting their digestive process and thinking about talking to them about chewing their food, sitting eating at a table, not with their legs crossed, and engaging the nervous system to expect food um, possibly something like lactose intolerance is quite is actually quite common, and so actually having a simple test for that which, um, because lactose is a sugar, which is, if it isn't digested, if you're missing the enzyme to break that sugar down, it sits in the gut and it basically ferments and it causes bloating and horrible sort of flatulence and burping and belching, and so actually just having a simple lactose test to see whether you've got the enzyme to break that down is very important. So working on the digestive system as well as the gut microbiome, is also really important to help improve their digestive process. To help improve their digestive process and allow again allow six months of proper intake of food before you expect the. You can't expect to be eating 2,000 calories for a month and then expect your cycle to kick back in. This can take six months.
Speaker 1:Yeah, which makes sense. Again, it's time, it makes sense, the brain's doing its job.
Speaker 2:It's like okay you were in danger.
Speaker 3:Yeah, okay, there's food coming in now, but I don't think I really trust you.
Speaker 1:Yeah, yeah, I always ask questions about pooing, but a lot of teenage girls are also constipated. Yes, about pooing, but a lot of teenage girls are also constipated. Yes, and does that have? Uh, because we excrete spent hormones. Yeah, so is that also an important thing for them? Just to for their general hormonal well-being?
Speaker 2:I think at this age, uh, it's definitely more important, sort of as we get older.
Speaker 2:But, for the purposes of this, for this age. Yes, I mean, it's a natural process we should be having a bowel evacuation at least once a day. A properly formed bowel evacuation, at least once a day, maybe twice, that's normal physiology. Maybe twice, that's normal physiology. So the downside of not doing that, of being and it's reframing the question to the girl, is that are you constipated? They're going to say no. How often do you pass a stool? Well, if it's twice a week, then that's not okay.
Speaker 2:So that is absolutely going to cause bloating. It is going to also cause um, it is going to cause a recirculation of yes, of already ready to be packaged up hormones for elimination, um, but any other sort of toxin as well. So that is going to have an impact, um, but also it is then going to change the community within the microbiome. So the microbiome is is most densely populated in the large bowel, the large intestine, and the bacteria and the fungi and the viruses that reside there, that form this beautiful community, play a really important role in our hormone balancing, in our immune system and also in terms of our in the way that we feel emotionally. So there is going to be a knock-on effect across all of those other systems as well, if someone's not eliminating properly.
Speaker 2:Yeah, Mm-hmm um, so now can we talk about heavy periods? Yes, so what constitutes a heavy period? So if you are bleeding for more than seven days, if you need to change your pad or your tampon like every hour for consecutive hours, for consecutive hours and days, that's heavy. And also if it's accompanied by pain that's not relieved by ibuprofen and anti-inflammatories, and there's no problem in taking ibuprofen for a couple of days. You don't need to be a martyr, it's very effective. And going back to again session one, it's quite common for periods to be more painful and heavier and more, let's, kind of crampy. Initially, because it's all oestrogen led right and when, with the car's bunny hopping down the road, we're learning the rope, so that is, and there's not very much progesterone coming into light in the period. Yeah, so, and then, similarly, they're also getting used to that process of that uterine lining shedding. That, that kind of carpet, that shag, pile, carpet, is release is the action of that, is the release of what are called prostaglandins, so chemical messengers that ibuprofen and non-steroidal anti-inflammatories work on. Okay, so that's sort of why women are experiencing that pain. So the reason for these painful periods can be, again, if they're not ovulating, because there's no progesterone to lighten the flow. So it comes back to all of those things we want to get that lovely ovulatory cycle working, all of the things that we spoke about in the last episode. Now, if they are sexually active, it is worth testing for STDs because that absolutely needs treating and that can cause painful, heavy flows and that mustn't go untreated and don't be a martyr. That needs to be done.
Speaker 2:Pelvic floor and the sort of chronic. There is a real connection between the nervous system. So this comes back to what you very intuitively were saying about the brain mel, in that we can, I also believe, be very I'm hesitating over this because this is not to disrespect any woman that has been given a diagnosis of endometriosis and adenomyosis, because they are highly debilitating conditions. But there is also a significant area that has been disregarded around that there is such an intrinsic link between the nervous system and the pelvic area, because the pelvic area is full of tiny nerve endings. So there can be this very common situation when young women are experiencing high levels of stress, like they're going through GCSEs and A-levels high levels of stress, like they're going through GCSEs and A-levels. This can cause pelvic pain and they may have some artificial lesion, endometrial lesions, which can just be natural physiology, rather than and you don't, we don't need to just jump straight to that diagnosis, so we need to kind of just work through that nervous system connection as well, okay, and then another very common area that needs to be thought about is histamine, because the uterus, uh, and all epithelial barriers, so we have, uh, these epithelial barriers, so we have these epithelial barriers in our skin.
Speaker 2:It's just like, yeah, an epithelial is a thin lining, pardon me, that lines the gut, that lines the uterus, that lines the lungs, the sinuses. They have a very dense population of certain cells called mast cells, and these mast cells contain histamine and also something called heparin. So every month, or approximately every month, when the uterine lining is shed, it is full of mast cells which can degranulate well, which do degranulate, because they've been aggravated and because it's an inflammatory process and they release their content. So you can get a surge of histamine I didn't know that, yeah yeah.
Speaker 2:So it is kind of quite. It is all interconnected. And histamine is also, interestingly enough, a neurotransmitter. We make histamine in the brain because it is actually an excitatory neurotransmitter, but in excess amount, like anything. I mean, we make it for very good reason because it gives us, but in excess it can lead to agitation, very like pms type symptoms. So histamine is histamine, is definitely something to think about. I think about when I'm thinking heavy periods, painful periods and or sort of mood. But just for what we're talking about here, heavy period I would be thinking about that.
Speaker 1:Okay, so, and that is where you've got too much histamine circulating. Well, for the purpose of what we're talking about here, it's really more that, it's just a natural.
Speaker 2:A massive place of residence is in the of. Where mast reside is in the uterine lining. So every 30, 40 days, when that lining is shed, naturally that process itself is inflammatory. It's releasing cytokines. Those cytokines have an affinity for mast cells. They dock onto mast cells like a key going into a lock. They unlock the mast cells. They dock onto mast cells like a key going into a lock. They unlock the mast cells. They go yippee. Okay, so we've now got inflammatory cytokines and now we've got a whole load of histamine and heparin. So that's going to make your period really heavy, right. So a way to trial, that is, you can just see for the for a couple of cycles. Okay, just try taking an antihistamine. I was gonna say is that? Uh, yeah, and you're lovely and they're a natural antihistamine. So an omega-3, so bare biology. I would take the. The um, life and soul, the liquid, the liquid yep so that provides three grams in one sitting.
Speaker 2:Um so omega-3s are what are called mast cell stabilizers and it's a double whammy. So it helps to kind of stabilize that mast cell. So it makes it, prevents it from degradulating. But the other, you've got a double win with this, well, actually a triple win you've got. Also, it's a natural anti-inflammatory, so it works on exactly the same pathways as ibuprofen. It stops those cox and or inhibits those prostaglandins, those inflammatory cytokines, and the DHA component of it has an affinity for the brain, so it helps with mood.
Speaker 2:So a teaspoon of Life and Soul is going to be anti-histaminergic, it's going to be anti-inflammatory and it's going to be neuroprotective. Sounds like a great product. Sounds like a great product.
Speaker 1:Sounds like a great product there's any way you can get it. Yeah, no idea. And if and if you are thinking there's no way, my daughter would take a liquid, which would be the ideal in this scenario. My daughter, yep, go on, takes double the capsules, so the Life and Soul daily capsules. She just takes four of those around that time and then two a day, sort of in between periods.
Speaker 2:And that's a great point that you bring up, because and it's a question I get asked a lot because we don't want to be just handing out handfuls of supplements we're bridging a gap and so for this purpose, they don't need to take them all month long, but up the dose as they're coming to their bleed and then go back down to the lower dose because it's an essential fatty acid. Ie, we don't synthesize it, we don't make it ourselves, but an omega-3 is, and their biology is my absolute go-to, is an essential for everybody, because we don't make it. So, yeah, really important um. And then the other element that is that can really help, and this can help with acne as well um, but the histamine component is avoiding A1 dairy. So I'm not and I'm specifically saying A1 dairy.
Speaker 2:So A1 is referring to the type of casein. So you've got your curds and whey, so A1 dairy, so you can get A2 dairy or you can eat you can be happily eat sheeps and goats dairy. So we're not removing all dairy, it's just a1 dairy um casein. And the reason is is that in, is that a1 dairy contains a protein which is called a peptide, um, which is uh, has an opioid like, so it can, and in some people they're not able to break that protein down and it has an affinity for mast cells, so it can aggravate histaminergic actions. Okay, so just removing A1 dairy. So cow's milk.
Speaker 1:So Jersey cow's is fine, so cow's milk, so Jersey cow's is fine. There's an. A2 milk.
Speaker 2:There's A2 and then you can get A2 milk.
Speaker 1:Or if you want to eat cheese, just go for sheep or goat but not cow.
Speaker 1:So no cheddar Parmesan out, but you could eat Pecorino instead of Parmesan, because that's sheep's milk. There you go, there you go. I'm also a chef, are you no? Instead of parmesan, because that's sheep's milk. There you go, there you go. Yeah, I'm also a chef. No, I'm not, are you no? I know quite a lot about cheese. Well, my um, my husband and my eldest daughter have casein allergies, but they love dairy. There you go, um. And just interestingly, I wonder if they would be okay and I think also have histamine issues with sheep and goat. Or would you not? If you have a casein allergy, would you avoid all?
Speaker 2:well, yeah, okay, casein is going to be in sheep and goats.
Speaker 1:So for this, for the purpose of what we're talking about here, which it's specifically, it's the a1 casein so anyone listening who's got casein allergy, don't get too excited and go off and eat a load of goat's cheese. Yeah, yeah, we're talking about this specific yeah, okay, yeah, yeah, okay.
Speaker 2:So, uh, now the other thing um to be my to be thinking about is this may sound counterintuitive, but checking for anemia, specifically iron, because an iron deficiency can make periods heavier right, which doesn't sound, which sounds counterintuitive, but I've seen this many, many times and why is that.
Speaker 2:So I think it's because the body has a very, very clever mechanism of it has a, uh, what's called a ferritin pool, and it has a very clever mechanism of keeping that pool, um, or the stores of ferritin in in the, in within the, within the right levels. So, um, the way, what's really important is to go to your doctor and ask them these. There's nothing esoteric about these, these are just standard markers. But they need to have a full what's called blood chemistry. So you're looking at your red blood cell count, you're looking at what's called hemoglobin, you're looking at hematocrit, and then you want a full iron panel which is looking at ferritin transferrin saturation percentage, and all of this just to check that she's not anemic, because if she's anemic, then that's going to make periods even heavier, right? So that needs to be addressed.
Speaker 1:And would there be other obvious symptoms of anemia, like fatigue?
Speaker 2:Fatigue very pale colour feeling breathless, walking upstairs if you can get them to walk upstairs, but yeah, just feeling really overwhelmed, lacklustre. Their hair just suddenly looks really dull and lifeless. That sort of breathlessness, breathlessness and and actually and heavy bleeding, bruising easily as well, is also another sign of of anemia. Now, a lot of those symptoms also can cross parallel with hypothyroidism. So this is why you looking at the lens of holistically is really important and not just jumping to a diagnosis, but that's really important. Zinc is again. Really there's a study here using zinc, same dose in the treatment of dysmenorrhea, so painful, heavy periods and, of course, omega-3. So this works on reducing the prostaglandins, the inflammatory cytokines, and which then go on to produce what are called specialized lipid sorry, specialized pro-resolving mediators. So these are our superpower anti-inflammatories, which are derivatives of the EPNDHA, which convert naturally in the body.
Speaker 2:So there's a lot there that we can do through a diet, lifestyle intervention, on top of maybe taking ibuprofen for a couple of days. All of those other components are really important.
Speaker 1:And I know people worry about taking ibuprofen my daughter included. Yeah, as long as you're, you've got a full stomach, right? You want to have food in your stomach?
Speaker 2:yeah, occasional use occasional times a month, with your exactly your period yes, it makes your life a lot easier exactly, absolutely, yeah, yeah, totally, um, and sort of going back to the car analogy, reminding her that she's just becoming. With each cycle she's going further down the road yeah, and it won't be like this forever because I think there's also especially when they're young.
Speaker 1:Maybe they're they're 14 or 13, it's just started and they've had a few. Totally I thought of have I got this for the next 40 years? Yes, every month. So it is daunting isn't it?
Speaker 2:yeah, it is. So that's why sort of really understanding why that ovulatory cycle is so important is, uh, with all of the, with these other tools to help to bridge the gap and alleviate that, that, those pain and these dietary tweaks along the way is a more yeah, I would say it's a much more sophisticated, bespoke approach where you're hearing them, you're here, you're you're and you're meeting them where they are and helping you and we're helping to guide them on that journey, rather than saying, oh, yes, that's awful, yeah, we'll turn that off. Yeah, because that isn't a solution at all. You're just kicking the can down the road. Yeah, that's kind of what we're doing, so great with that, what's next? What's next is PMS. Pms, lovely, lovely, yes.
Speaker 2:So with PMS, this, the thing that I would I that I think is going to be most helpful to explain about PMS is that there is a real intersection with the ovarian produced hormones, so the oestrogen and the progesterone, and the neurotransmitters that are produced in the brain, in that to make serotonin and dopamine. So serotonin is our feel-good reward. Neurotransmitter, dopamine is all about drive and motivation. Okay, so with all of these neurotransmitters, we, it's a bell-shaped curve, isn't it? We want there to be. We want to sit in the middle where we want to feel happy content. We want to have drive. We want to sit in the middle where we want to feel happy content. We want to have drive. We want to have ambition, but we don't want to have and we don't want to have apathy and um and inertia, but we don't want to be stressed out and we don't want to and we don't want exactly.
Speaker 2:We don't want mania. Yeah, so it's a, it's a happy medium. So the reason that there is this interplay is that estrogen and progesterone, together with foundational nutrients like vitamin D, omega-3 and zinc, and your B12s well, all of your B vitamins, vitamins are needed in the synthesis of our neurotransmitters, so the making of our neurotransmitters, and also, importantly, in the removal when of those neurotransmitters. So, as an example, estrogen is involved in making serotonin, but also it's involved in there's a little enzyme which helps to remove oestrogen from the system when it's done its job. So if there is too much or too little of that oestrogen, it will impact that and you can then have these neurological symptoms, okay. So, similarly, we also want to make sure that we are thinking about differential diagnoses of have we ruled out anemia, rather than saying, oh, it's your hormones, your, your, your, you've got pms. So fatigue, uh, dizziness, racing heartbeat, anxiety, because the body, body is basically craving oxygen, so you get the, the heart rate goes up to try and get more oxygen. Um, easy bruising, I've that sort of brittle nails. So those are symptoms of anemia. But you also want to be ruling out disordered eating, hypothyroidism, you want to check that all of those are not in the picture and also talking about substance abuse. That conversation has to be had in terms of these mood symptoms. And, of course, have they been on the oral contraceptive pill for a period of time? Because we know by the study that we showed last week that that can have an impact, can have an impact. So the first thing that I'd want to cover off with PMS is have they got any dysregulation of blood sugar? Because symptoms of blood sugar that spikes and then plummets is sweating, feeling shaky, anxiety, inability to stay asleep or they can't fall asleep anxiety, depression, low mood, hair thinning. So does that not all sound like, oh, it's your hormones? Well, actually, if we stabilize your blood sugar and a classic sign at this age is if they say they're not hungry or they feel sick, they don't want to eat breakfast, that's a classic sign of dysglycemia. So having some kind of protein in the morning to actually just that will actually help to level out their blood sugar. But if they're walking out the door feeling sick and anxious, then that and thinking that that's PMS, then we're kind of we're barking up the wrong tree. So that's definitely something that we that we want to think about.
Speaker 2:And then the estrogen component is also important. So estrogen helps to. It increases an enzyme that is needed to make to take tryptophan, which is an amino acid that we get from protein food, and convert it into serotonin. And then estrogen also decreases the enzyme that actually removes serotonin from the receptor. So this is why in the second half of the cycle, when oestrogen drops, we can experience that lower mood. We can experience that lower mood. Okay, now, interestingly enough, the estrogen, the ethanol, estradiol that's in the pill, does not have this impact at all. It can't, it doesn't help the neurotransmitter synthesis at all and this is why it has such a massive impact neurologically as well.
Speaker 1:I was going to ask you that because when you said estrogen helps you make serotonin, yes, if you're on the pill, you have no estrogen.
Speaker 2:Well, you do, you have ethanol, but the brain doesn't recognize it in the same way. So when we're making these neurotransmitters, it's like making a recipe. It's you're adding in all of these ingredients. That doesn't, it's not the same. No, it doesn't.
Speaker 1:It doesn't make up that, it doesn't it's a bit like when you make a gluten-free cake yeah, and rice flour, yeah. It's just not the same as wheat flour, exactly. Yeah, yeah, because it doesn't have the gluten exactly because it yeah so it doesn't work as well.
Speaker 1:So it doesn't work as well, cheer cheer egg is quite good cheer egg yeah, mixing, oh, when you make, yeah okay, yeah, we'll do a whole episode on cheer eggs. Yes, understood, so that's enough. So's a lot of girls report feeling incredibly depressed on the pill, which is also, I know we're not making the right levels of serotonin.
Speaker 2:Uh, actually, this triggers an insulin surge, right, and that triggers cravings crikey okay I know, that makes sense, doesn't it?
Speaker 1:yeah, because you think why am I suddenly craving a?
Speaker 2:biscuit boost. Yeah, and that happens in the second half of the cycle more commonly. So, yeah, if we're constantly, if we're not, that's why we need another re-. So there is such a connection between our ovarian hormone production and our neurochemistry. It's fascinating, hey, so interesting. And our neurochemistry it's fascinating, hey, so interesting. And I said I alluded to this, but just to be also clear I also talked about histamine, that we make histamine in the brain as a neurotransmitter. So at times in the menstrual cycle where oestrogen is in ascendance so around day 14, where all those follicles are pumping out oestrogen, and then right at the end of the cycle where both oestrogen and progesterone are on the downturn, but right at the end there is just this slight uptick of oestrogen over progesterone. Over progesterone, estrogen uh has an affinity for mast cells and so it will. It can actually aggravate mast cells to degranulate and release more histamine, and histamine is an excitatory neurotransmitter. So that can lead to that, that kind of mania we want to kill people.
Speaker 2:Yes, yeah, so that men in the room are laughing nervously so it is, yeah, a beautiful symphony that when we know this and we can actually maybe take some omega-3 mid-cycle as well, just to help, and those marcells stay that's how I know my period's about to start is because I, out of nowhere, feel intense rage and agitation there you go, it's fun for everyone, though I managed to keep a hold of it, but whereas my daughter will get very emotional and very tearful right before, yeah.
Speaker 2:So those hormones, yeah, they've all. They've plummeted they've all gone and she's feeling a bit like the carpet's been pulled away from her. Yes, yeah, which it has essentially Everything's terrible. Yeah.
Speaker 1:So much doom and gloom and I say your period's about to start and the next day she goes oh, you were right, and she feels totally different. Yeah, yeah.
Speaker 2:So again, that's sort of another conversation around our society. If the menstrual cycle is accepted as a as a vital side of life and and and there are these fluctuations then shouldn't it be normal for in those days running up to a period or just that, that actually it's the quieter, more introverted days that you stay at home, you work from home, that you're just, you're not actually, you're not set up to be engaging in the world and play and being out in your power as you are in the, the, the, in the follicular phase yeah it's, uh, it's, it's a.
Speaker 2:It's a more powerful way to look at it definitely.
Speaker 1:But there are a lot of women now who do that, don't they? They track their yes and then there are apps that tell you okay, today's the day to do that. I really like interview.
Speaker 2:Daisy is a really nice one. Okay, dy right. Yeah, that's it's. It's actually it's a fertility app, but it's actually. It's really great at tracking temperature and and ovulatory cycles.
Speaker 1:It's a really nice one, yeah, I wish I'd known about that when I was young, because now it doesn't really work for me. Does it anymore? That whole? I don't. I've lost my power you haven't lost your power. I've got new power, I've got different power, but yeah I think, for young women, I think, I mean, obviously it's not always possible. Sure Wouldn't it be great if you could do your A-level on the day you're about to ovulate.
Speaker 2:I know, I know yeah.
Speaker 1:Instead of the day before your period starts, I know but you know, but yeah, wouldn't that be great if you could work with it?
Speaker 2:We'll put that to the exam board. Yes, in our lifetime, yeah time, yeah, so naturopathic treatments for this with ensure stable blood sugar really important. And you just think about those symptoms of hypoglycemia. You feel shaky, you feel anxious, you start sweating, you feel wobbly, tearful. Okay, sit down, have a hard-boiled egg I mean that yeah that don't, but actually, yeah, it is.
Speaker 2:Or have some, you know, just sit and have a hard-boiled egg. I mean that again, but actually it is. Or have some, you know, just sit and have a couple of crackers and some cheese.
Speaker 1:So a typical teenager who might have had a can of Coke and a packet of wine gums On their way back down, yeah. And then they feel terrible yeah. Actually yeah pop it into a press and get a couple of boiled eggs.
Speaker 2:Yeah, much better yeah to press and get a couple of boiled eggs or, yeah, yeah, much better. Yeah, um. So stabilizing blood sugar, marcel stabilizers. So omega-3 quercetin is also really lovely. Um, a lovely. Another lovely nutrient called nigella, which quite often comes with quercetin and many formulas removing the A1 dairy. That's a really nice combination. So you're looking at balancing blood sugar, removing just that A1 dairy and those nutrients. Optimize vitamin D, because vitamin D is also involved in making all of those making serin, making melatonin, making dopamine. So get vitamin d levels checked twice a year and supplement accordingly. Keep it, keep those at an optimal level, check for anemias and balancing and exercising, being out in nature and good sleep hygiene Really difficult in terms of that phone out of their bedrooms, which we have far less control over at this age, but at least ensuring that they are sleeping and that they are not nocturnal and then sort of staying in bed till midday, um, it's really important to calibrate that circadian rhythm.
Speaker 1:Yeah, really really important and ideally get some sunlight in the morning.
Speaker 2:Yeah, rather than phone light sunlight in, it's like, even if it's just so within 30 minutes of waking that cortisol awakening response.
Speaker 2:So just taking them a cup of tea or whatever they're having just sat on the step outside yeah, so they're getting exposure to that uv light through through the cornea is really, really important. Yeah, it's really important. Um, and this is a really fantastic study that I think I've shared with you before, but this was the evaluation of omega-3 fatty acids, with 124 women who were prescribed 2 grams of omega-3. And, after 45 days, the severity of their depression, anxiety, lack of concentration, bloating were significantly lower in the group that took the omega-3. Amazing, so it is a completely holistic approach. Yeah, but this is the way forward to support these young women. Yeah.
Speaker 2:And I think that that is the takeaway message to support that yeah, I love it.
Speaker 1:Thank you so much on that note um you mentioning vitamin d and testing your vitamin d levels oh yes um, people who listen to this, who don't know who I am and I don't, you know, do a lot of product plugging. But we don't have sponsors.
Speaker 1:It's effectively sponsored by Bayer Biology which is the company I founded and I'm the CEO of. Which. We started off as a very specialist Omega 3 brand, because I love Omega 3 so much because it's insanely brilliant at pretty much everything. But we also have a vitamin D called Beam and Balance, which has no sugar in it, and we also have a vitamin D test. So for your omega-3 and vitamin D and your vitamin D test, come to us.
Speaker 2:You can come to Mare Biology absolutely and well, we'll be doing more episodes. The next one's covering the pill the next one's covering the pill and acne, so we'll do those two.
Speaker 1:So those go hand in hand.
Speaker 2:So it's been such fun, such fun to talk about menstrual cycles, periods, women's health in general. So bring on the next one. Bring it on, thank you.